Beaumont Court Orders Employer’s Suit to be Dismissed
The Ninth Court of Appeals, sitting in Beaumont, has ordered the dismissal of a suit filed by an employer against its former workers’ compensation carrier because the employer failed to exhaust its administrative remedies. In In Re: Texas Mutual Insurance Company (No. 09-15-00265-CV) the Court wrote:
The Division has exclusive jurisdiction “for claims arising out of a carrier’s investigation, handling, or settling of a claim for workers’ compensation benefits.” In re Crawford & Co., 458 S.W.3d 920, 925-26 (Tex. 2015). [The employer’s] claims fall within the Division’s exclusive jurisdiction and “the Act provides the sole process and remedies for those claims.” Id. at 928. According to the record before us, [the employer] has not pursued the administrative process that is a prerequisite for judicial review. Id.; see also Tex. Labor Code §§ 410.252, 410.302 (West 2015). The trial court lacked subject matter jurisdiction; therefore, it was an abuse of discretion for the trial court to deny the motion to dismiss. [The carrier] is entitled to mandamus relief. Crawford & Co., 458 S.W.3d at 928.
The carrier had denied the claimant’s claim for workers’ compensation benefits because the workers’ compensation policy had expired approximately three weeks before the date of injury. The employer sured the carrier and asked the trial court to order it to provide workers’ compensation benefits to the claimant and to reimburse the employer for medical expenses that it incurred in connection with the injury. The carrier filed a challenge to the trial court’s jurisdiction, arguing in part that the employer had not presented a claim to the Division. The employer responded and argued that the trial court had jurisdiction over the claim because the claim was based on a theory of equitable estoppel. The trial court denied the carrier’s motion to dismiss the suit for lack of jurisdiction.
The employer argued that the trial court had jurisdiction to determine whether the carrier waived its right of cancellation pursuant to the Beaumont Court’s 1970 decision in Dairyland County Mutual Insurance Company of Texas v. Mason. The court of appeals rejected the argument, noting that Mason had been decided before the 1989 reforms to the workers’ compensation act. The court wrote, “The Act now provides an administrative dispute resolution process for claims for workers’ compensation benefits, including a claim for reimbursement by a subclaimant such as [the employer]. Id.; see also Tex. Labor Code Ann. § 409.009 (West 2015).”
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